English proficiency and physicians' recommendation of Pap smears among Hispanics

Cancer Detect Prev. 2006;30(3):292-6. doi: 10.1016/j.cdp.2006.05.003. Epub 2006 Jul 17.


Background: Hispanics have one of the highest incidence rates of cervical cancer. Physician recommendation is one of the most important cues to cancer screening; however, low English proficiency among Hispanics may hinder health providers' recommendation of Pap smears.

Methods: Analysis of data from the 2000 National Health Interview Survey. All Hispanic women, age > or =18, without a Pap smear in the past 3 years or ever and who visited a health care provider in the past year were included. The main outcome was receipt of Pap smear recommendation by a health care provider.

Results: A total of 314 Hispanic women were included in the analysis, 44.9% were highly English proficient. Only 7.7% of low English proficient Hispanics not up-to-date in cancer screening reported a recommendation for a Pap smear as compared to 14.3% of highly proficient Hispanics. After adjusting for sociodemographics and health access and utilization factors, highly English proficient Hispanics were more than two times as likely to report receiving a recommendation for a Pap smear as compared to the less proficient (aOR 2.2, 95% CI 1.1-4.5).

Conclusions: Low English language proficiency is a barrier to receive a recommendation for Pap smear among Hispanic women not up-to-date with cervical cancer screening. Further research is needed to explore specific mechanisms responsible for the low recommendation rates and to assess the impact of interpreters or Spanish-speaking providers on Pap smear recommendation rates.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Communication Barriers
  • Cytodiagnosis / statistics & numerical data
  • Female
  • Health Services Accessibility
  • Hispanic Americans
  • Humans
  • Language
  • Mass Screening
  • Papanicolaou Test*
  • Patient Acceptance of Health Care
  • Physician-Patient Relations
  • Socioeconomic Factors
  • United States
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / ethnology
  • Vaginal Smears / statistics & numerical data*